HomeMy WebLinkAbout07030093 Application
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City of Carmel/Clay Township Permit#: D,03 DO<~S
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
I
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER NAME:
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
.
7.
CITY: STATE: ZIP:
Tt\) .LIJ <{. 2 '?
BEST METHOD OF CONTACT:
FAX:
CITY: STATE: ZIP:
I
ZONING:
CC F CONSTR CTlm~ s-
Subjc:ct to cornp"unce w,th all r. g!l(\il~iW's
of Statn and Locai Cod~>.,,?OTAGE: 5{pOtJ.
'T. ~.r:"---1'''''r.'''''~ ill 'I\, i-r ,..U
DE .m"", roo COST'GF'CON 0 etf:'
I~CLUDINGL<o ND:VALUE, ~
ui- \....I\n!VjL~'- I c(
o '-:INDIANA ,I 0 00 i
c.', 'c.\':~ -610'.30!s@ I
1 4 2007:\ 11\
\I~\
------~---j '\
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SECTION:
SEWER UTILITY WATER UTILITY
PROVIDER: PROVIDER: C
NAME OF UTILITY EXCAVATION COI'ITRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
-y4
_Y IN
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
-4_N
..LY _N
JD
TAX MAP PARCEL #:
\1 1'\ \
,I, '..,
1,1 \1(
PLUMBING CONTRACTOR:
i W \-';, . ,~.-
hI L SMd:/-l Lv'-- .
Plumber's IndianalState License.#:___.__--------
!.--'---'--
10/777
Whi9 plumbing codes will be applied to the construction:
(]( International Residential Code w/Indiana Amend~ents
o Unifonn Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) I
o CRAWLSPAC}- 0 POST & BEAM PIER
o SLAB <>f BASEMENT (WALKOUT:_Y ~)
For Single Family and Two Family dwellings, additions. remodels. and/or accessory structures, this pennit is valid only if construction commences -within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. pass I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been issued by the Department of Community Services, Cannel, Indiana.
.. .
J.oR~ f}_ PJ;RbStltJr,- J./~I\lI;fIlF
Print
J.Ja/Pb7
Date
OFFICE USE ONLY: * *****************************~~**********************'l*f,**********************
INSPECTIO UIRED: FIling Fees: ,7':.::20
Base Inspections: ;2--;?1.~
Cert. of Occupancy: J:3, )'0
P.R.I.F.~. 6 f.
;.cn)T~: ,4
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~
:Permits/FormS/IlP RESIDENTIAL
Under Slab
Site
# Charged Re.
ReViews
Additional Fees
Fee Received by:
Date